An Advance Directive is an oral or written communication which states preferences for healthcare decisions and may appoint an agent or surrogate to make health care decisions when one is unable to do so.  It may also appoint someone to make such decisions, even when the person retains the capacity to make informed decisions.  Currently in California, the “Advance Health Care Directive” form is recommended.  Other examples of written advance directives include the “Durable Power of Attorney for Health Care” and “Living Will”. 
All Patients, who have an Advance Directive, that has been witnessed, is responsible to bring a copy to the healthcare team responsible for their care and this copy will be a part of their medical record.  The Physician must be made aware of the existence of it. 
Valid Advance Directives are effective indefinitely unless they specify a certain period of time.  A new Advance Directive is completed if the patient wants to make updates or changes.  The date and word “VOID” are written on previous copies.  Patients may change their mind and rescind their Advance Directives at any time, either verbally to their physician or in writing.  Changes must be made in the patient’s medical record. 

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